{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/personal-care-and-service-workers-all-other/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Personal Care and Service Workers, All Other",
    "soc_code": "39-9099",
    "category": "Personal Care",
    "us_employment": 60420,
    "median_annual_wage": 41600
  },
  "verdict": "EXPOSED",
  "risk_resistance": 54,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 15,
    "embodiment": 16,
    "liability_shield": 3,
    "trust_premium": 12,
    "judgment_accountability": 8
  },
  "reasoning": {
    "task_resistance": "Walking a frail companion client to the toilet, holding a bride's train at the church door, or staying awake overnight as a sitter are tasks no software executes — 15 rather than 18 because the paperwork these workers do carry (intake forms, activity logs, shift notes, mileage and hour reporting) plus the client-matching and scheduling that fills the gaps is already being absorbed by apps.",
    "embodiment": "The work happens in other people's homes, hotel ballrooms, funeral chapels, locker rooms and pool decks — uncontrolled spaces with wet floors, unpredictable stairs, agitated or grieving people, and physical contact from a steadying arm to lifting a wheelchair footrest, which is why this sits at 16 and not higher only because it rarely involves heavy machinery or clinical procedures.",
    "liability_shield": "Companion and sitter work is specifically carved out of most state nurse-practice acts precisely because no licence is required — a background check, CPR card, and sometimes a food-handler or pool-attendant permit is the ceiling, so a 3 reflects screening, not credentialing, and the agency's insurance carries the exposure rather than the worker's name.",
    "trust_premium": "A family choosing a sitter for their mother, or a funeral home sending the same attendant to greet the same congregation, is buying that specific person's manner — but 12 rather than 16 because agency and platform staffing means substitutions happen weekly, shifts get covered by whoever is available, and most wedding or locker-room assignments end when the event does.",
    "judgment_accountability": "Real calls happen — deciding a client is confused enough to phone the family, deciding a chaperoned teenager needs to be separated from a group, deciding a guest is too intoxicated to drive from the reception — but the standing instruction is escalate to the agency, the nurse, or the family, so at 8 the discretion is about recognising a situation, not owning the resolution."
  },
  "rationale": "This is a residual catch-all — companions and sitters, wedding and funeral attendants, chaperones, bath and locker room attendants, doula-adjacent and non-medical support roles — and the modal worker spends the day physically present with a client, escorting, assisting, supervising, and reassuring. Almost none of that is text or screen work AI can take, and no robot can walk a frail client to the bathroom or calm a nervous bride. What is exposed is the coordination layer around the work: scheduling, client matching, intake paperwork, activity planning, and the platform middlemen who currently connect these workers to clients.",
  "outlook": "The face-to-face work stays, but wages stay compressed and the agency back office thins out; the workers who add a care credential or own their client book will earn meaningfully more than those who stay on generic shift assignments.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "liability_shield",
        "change": "State-level certification/registry mandates for non-medical companion and in-home care workers tied to Medicaid HCBS billing — e.g. the CMS Access Rule's 80/20 direct-care compensation provision plus state background-check and training registries (Washington's HCA certification for long-term care workers is the closest existing model). If a state requires a registered individual to be named on the service log for reimbursement, and that individual carries mandatory-reporter duty for suspected abuse/neglect, the shield stops being nominal.",
        "plausibility": "plausible",
        "would_add": 4
      },
      {
        "dimension": "liability_shield",
        "change": "Doula licensure/Medicaid reimbursement pathways already enacted in ~a dozen states (e.g. Oregon, Minnesota, Rhode Island, Michigan) create a credentialed, enrollable provider with a scope of practice. This only lifts the sub-segment of the residual code that is doula-adjacent, not chaperones or locker room attendants.",
        "plausibility": "already happening",
        "would_add": 3
      },
      {
        "dimension": "trust_premium",
        "change": "Buyers in this category are already paying for physical human presence, so the premium is not about anti-AI branding but about defection from platform intermediation: if Care.com/Papa-style matching layers are seen as extracting margin while AI handles matching, direct-hire and agency-of-record relationships where the family chooses a named individual raise the identified-human component. Watch for state domestic-worker bills of rights (NY, Seattle, Philadelphia) extending written-agreement requirements to companion care.",
        "plausibility": "plausible",
        "would_add": 3
      },
      {
        "dimension": "judgment_accountability",
        "change": "Task-mix shift plus formal escalation duty: once scheduling, intake and activity planning are automated, the residual day is fall risk, cognitive decline observation, and deciding when to call 911 or a family member. If state HCBS rules or agency contracts require the companion to document and escalate change-of-condition observations (already standard in some assisted-living aide protocols), the role owns a consequential call under ambiguity rather than merely reporting hours.",
        "plausibility": "plausible",
        "would_add": 4
      }
    ],
    "ceiling_note": "This is a residual SOC bucket, so levers apply unevenly: doula and companion-care segments have real licensure and Medicaid pathways in motion, while wedding/funeral attendants, chaperones and locker room attendants have essentially no route to a liability shield and their trust premium is wage-suppressed rather than credential-protected. Aggregate score gains would likely be diluted by the non-care half of the code, and the automatable coordination layer keeps downward pressure on hours even where the in-person task is safe."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2017,
        "emp": 56820,
        "wage": 25900
      },
      {
        "y": 2018,
        "emp": 58970,
        "wage": 26180
      },
      {
        "y": 2021,
        "emp": 72030,
        "wage": 29610
      },
      {
        "y": 2022,
        "emp": 59310,
        "wage": 34670
      },
      {
        "y": 2023,
        "emp": 60390,
        "wage": 36980
      },
      {
        "y": 2024,
        "emp": 62390,
        "wage": 37900
      },
      {
        "y": 2025,
        "emp": 60420,
        "wage": 41600
      }
    ],
    "from": 2017,
    "to": 2025,
    "change_pct": 6.3,
    "comparable_from": 2019,
    "spans_soc_revision": true
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}